HomeMy WebLinkAboutBuilding Permit Application ALLAPPLICABLE INFO MUST BE COMPLETED FOR APPLICATION TO BE ACCEPTED
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Building Permit Application MAR 2 8 2017
Planning and Development Services
Building and Code Regulation Division PER,10ffTING
2300 Virginia Avenue,Fort Pierce FL 34982 St. Lucie County, FL
Phone:(772)462-1553 Fax:(772)462-1578 Commercial Residential xxxxxx
PERMIT APPLICATION FOR: To Select from dropbox, click arrow at the end of line E1c(,4gi6A
PROPOSEDr:IIVIPROVEMENT LOCATION r K
Address:
Legal Description:
Property Tax ID..#. 6/-S0;2 — .�o I G`/,�'d — GuG I Lot No.
Site Plan Name: Block No.
Project Name:
Setbacks Front Back: Right Side: Left Side:
DETAILED DESCRIPTION OF WORK t
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remove existing pedestal install new
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Add
CONSTRUCTION INFORMATION ' _
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itiona wor to e e orme under this permit—check all appy:
HVAC I_J Gas Tank ❑Gas Piping Shutters Q Windows/Doors
Electric 0 Plumbing Sprinklers Generator Roof
Total Sq.Ft of Construction: ! CV
.Ft.of First Floor:
Cost of Construction:$ /f��UU Utilities- Sewer OSeptic Building Height:
OWNER/LESSEE, � � r y _ ti 1 YCONTRACTOR,}.
Name 'Ei,4--k�, rte, ..�r v� �- Name: John R Law
Address:_ —7(a(o L e n Company: Law's Electrical Service Inc
City: C o v a -e v v, l l e State: '1 Address: 5158 NW Primm St
Zip Code: e-1 !2 Fax: City: PT ST Lucie State:FL
Phone No. Zip Code: 34983 Fax:
E-Mail: Phone No. 772 370 4357
Fill in fee simple Title Holder on next page(if different E-Mail: johnlaw5158@aol.com
from the Owner listed above) State or County License: 29432
If value of construction is$2500 or more,a RECORDED Notice of Commencement is required.
DESIGNERIENGINEER: Not Applicable MORTGAGE COMPANY: Not Applicable
Name: Name:
Address: Address:
City: State: City: State:
Zip: Phone: Zip: Phone:
FEE SIMPLE TITLE HOLDER: Not Applicable BONDING COMPANY: Not Applicable
Name: Name:
Address: Address:
city City:
Zip: Phone: Zip: Phone:
I certify that no work or installation has commenced prior to the issuance of a permit
St Lucie County makes no representation that is granting a permit will authorize the permit holder to build the subject structure
which is in conflict with any applicable Home Owners Association rules,bylaws or and covenants that may restrict or prohibit such
structure.Please consult with your Home Owners Association and review your deed for any restrictions which may apply.
In consideration of the granting of this requested permit,I do hereby agree that I will,in all respects,perform the work
in accordance with the approved plans,the Florida Building Codes and St.Lucie County Amendments.
The following building permit applications are exempt from undergoing a full concurrency review:room additions,
accessory structures,swimming pools,fences,wails,signs,screen rooms and accessory uses to another non-residential use
WARNING TO OWNER:Your failure to Record a Notice of Commencement may result in your paying twice for
improvements to your property.A Notice of Commencement must be recorded and posted on the jobsite
before the first inspection.if you intend to obtain financing,consult with lender or an attorney before
commencing work or recording your Notice of Commencement.
s
–Signature Owner/Lessee/Agent Signature of Con ctor/License Holder
STATE OF FLORMAJ STATE OF FLO
COUNTY OF LC(? COUNTY OF _14-IRD4
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The forLoing instrument was acknowledged before me The forgoing Instrument was acknowledged before me
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_Zdayof this ;Llday of
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(Name f Person acknowledging) (Name e,,,acknowledging)
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(Signature ofNotary Public Stat o'fFlorfcfa) (Slgnatiure of Notary Public-State of Florida
Personally Known OR Produced Identification Personally Known OR Produced Identification
Type of Identification Produced Type of Identification roduced
Commission .--.1– Commission No. 13/0 (Seal)
ANNE BROWN wALmACH
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EXPIRES April 21.2020 MYC
Revised %4 ON#
EXPIRES 63
ft—
REVIEWS FRONT ZONING SUPERVISOR PLANS, VEGETATION SEA��" 'GROVE
COUNTER REVIEW REVIEW REVIEW REVIEW REVIEW REVIEW
DATE
COMPLETE
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INITIALS